Application of high-concentration iodine contrast agent in brain-heart combined CT angiography

ZHAO Xiaojing; ZHAO Cheng; CUI Yadong; ZHANG Miao; LU Jie

doi:10.19300/j.2025.L22043

Abstract：Objective To investigate the optimization effects of using wide-detector CT combined with a high-concentration iodine contrast agent on image quality and radiation dose in brain-heart combined CT angiography(CTA).Methods A retrospective analysis was conducted on 70 patients who underwent brain-heart combined CTA with wide-detector CT.In the study group(35 cases),coronary CTA(CCTA)was performed at 100 kV and head-neck CTA(HNCTA)at 80 kV,using a contrast agent with 400 mg/mL iodine concentration.In the conventional group(35 cases),both CCTA and HNCTA were performed at 100 kV using a contrast agent with 320 mg/mL iodine concentration.Subjective image quality of the head-neck and coronary arteries was evaluated using the Likert scale.Image quality metrics,including vascular CT attenuation,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR),were analyzed.Differences in image quality and radiation dose parameters between the two groups were compared using the chi-square test or independent sample t-test.Results The subjective image quality score of head-neck arteries in the study group was significantly better than that in the conventional group(P＜0.05),whereas no significant difference was observed for coronary arteries between the groups(P＞0.05).In HNCTA,the CT values of the ascending aorta,common carotid artery,internal carotid artery,and middle cerebral artery were all higher in the study group compared to the conventional group(all P＜0.05),with increases of 25.2%,28.0%,20.0%,and 16.7%,respectively.The SNR of the common and internal carotid arteries was lower in the study group,while the SNR of the ascending aorta was higher(all P＜0.05).In CCTA,the CT values at the aortic root and obtuse marginal branch were lower in the study group(both P＜0.05),while the CNR values at the left anterior descending and obtuse marginal branches were higher than in the conventional group(both P＜0.05).The dose-length product(DLP),effective dose(ED),and total ED of the HNCTA part in the study group were significantly lower than those in the conventional group(all P＜0.05).Conclusion Wide-detector CT combined with a high-concentration iodine contrast agent can improve image quality of both head-neck and coronary arteries while reducing radiation dose in brain-heart combined CTA,demonstrating high clinical application value.